Individual
ELSIE JUNE CHARGING CROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
511 N 12TH ST E, RIVERTON, WY 82501-3805
(307) 856-9281
Mailing address
PO BOX 1310, RIVERTON, WY 82501-0158
(307) 856-9281
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WY
Other
Enumeration date
03/06/2023
Last updated
03/28/2023
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